Sleep Quality Should Be Assessed in Inpatient Rehabilitation Settings: A Preliminary Study.

OBJECTIVES: In this preliminary, longitudinal study, our objective was to assess changes in sleep quality during an inpatient stay in a rehabilitation setting in the United States and to relate changes to patients' demographic and clinical characteristics (i.e., age, gender, BMI, ethnicity, reason for hospitalization, pre-hospital living setting, prior diagnosis of sleep disorders, and mental health status). METHODS: A total of 35 patients participated in this preliminary study (age = 61 ± 16 years old, 50% <65; BMI = 30 ± 7 kg/m2; 51% female; 51% Caucasian). The average length of hospitalization was 18 ± 8 days. Reasons for hospitalization included orthopedic-related issues (28%), spinal cord injury (28%), stroke (20%), and other (23%). In this sample, 23% had prior sleep disorders (mostly sleep apnea), and 60% came from an acute care unit. Patients' sleep quality was assessed using the Pittsburgh sleep quality index (PSQI) at admission and before discharge. Demographic and medical data were collected. Patients' mental health status was also assessed at the same intervals. Nighttime sound levels and the average number of sleep disturbances were also collected throughout the study (6 months). RESULTS: Our data revealed that most patients had poor sleep (PSQI > 5) at admission (86%) and discharge (80%). Using a repeated ANOVA, a significant interaction was obtained between sleep quality and the presence of a diagnosed sleep disorder [F (1, 33) = 12.861, p = 0.001, η2p = 0.280]. The sleep quality of patients with sleep disorders improved over their stay, while the sleep of patients without such disorders did not. The mean nighttime sound collection level averages and peaks were 62.3 ± 5.1 dB and 86.1 ± 4.9 dB, respectively, and the average number of sleep disturbances was 2.6 ± 1.1. CONCLUSION: The improved sleep observed in patients with vs. without sleep disorders might be related to the care received for treating such disorders over the stay. Our findings call for the better detection and management of poor sleep in acute inpatient rehabilitation settings. Furthermore, if our findings are replicated in the future, studies on the implementation of quiet times for medical staff, patients, and family should be performed to improve sleep quality in the inpatient rehabilitation setting.

Fibromyalgia status and depressive symptoms are linked to body mass index and physical performance in mid to late life.

Fibromyalgia (FM) is a chronic pain condition that is frequently accompanied by comorbid conditions, including depression. Depression is associated with reduced physical functioning and health, disproportionately affecting middle-aged and older adults with FM. This study examined associations between FM status and depressive symptoms with body mass index (BMI) and several physical performance indicators among middle-aged and older adults. Participants included 239 community-dwelling middle-aged and older adults with or without FM. Depressive symptoms were measured using the Beck Depression Inventory-II (BDI-II), BMI was objectively assessed, and physical performance was measured using the Fullerton Advanced Balance scale, 6-minute walk test, 30-second chair stand, and 8-foot up and go test. A path model using structural equation modeling yielded good fit and revealed that, compared to pain-free adult controls, participants with FM reported more depressive symptoms, which were in turn associated with reduced physical performance across all indicators except BMI, after adjusting for age and symptom severity. Findings suggest that individuals with FM demonstrate disproportionately higher depressive symptoms compared to non-FM controls, which may diminish physical performance after accounting for age and symptom severity. This study supports FM status and depressive symptoms as important considerations when evaluating the health and disability risk of aging adults.

A structural model examining racism, stress, and psychological symptoms among Arab American adolescents.

OBJECTIVE: Previous minority stress scholarship has investigated racism as both a constituent to stress and as an independent psychosocial stressor. It is generally understood that experiences of racism operate differently to affect mental health outcomes compared to general life stress. Racism is consistently implicated in poor psychological health outcomes among Arab Americans. Experiences of racism may be particularly harmful among Arab American adolescents who are in a critical developmental period. This study tested a minority stress framework among Arab American adolescents by examining the association between racism and psychological symptoms both directly and indirectly via stress. METHOD: The sample included 223 Arab American adolescents whose ages ranged from 13 to 18 (M = 15.63, SD = 1.26; 51.1% boys; 49.3% Lebanese) drawn from the Detroit metropolitan area. Participants responded to measures of racism, stress, and internalizing and externalizing psychological symptoms. RESULTS: The structural equation model provided good model fit to the data and indirect effects testing showed that the association between racism and psychological symptoms via general stress was statistically significant (z = 3.48, p < .001). Greater racism was associated with more psychological symptoms in the presence and absence of general stress. The magnitude of the association between racism and psychological symptoms was attenuated with stress included in the model. The association remained statistically significant and reasonably robust. CONCLUSIONS: Findings support racism as both a unique construct and an adjunct to general stress that is positively correlated with psychological symptoms among Arab American adolescents. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of pain intensity and depressive symptoms in the relationship between sleep quality and postural control among middle-aged and older adults with Fibromyalgia.

OBJECTIVE: Fibromyalgia (FM) is a chronic pain condition often accompanied by sleep problems and depression that are each associated with reduced physical ability including postural control. Research supports a sequential association between pain intensity and depression in FM, and poor sleep quality may play a key role in this relationship. This study aimed to verify a serial pattern of associations among sleep quality, pain intensity, and depressive symptoms and quantify these effects on objective postural control. DESIGN: Community-residing adults diagnosed with FM (n = 155; Mage = 61.08, SD = 7.70; 93% female; 79% White) were included in this cross-sectional study. MAIN OUTCOMES: Participants self-rated sleep quality (restorative sleep, sleep waking, and sleep latency), pain intensity, and depressive symptoms, and the Fullerton Advanced Balance (FAB) scale and 8-Foot Up and Go Test (8FUPGT) measured objective postural control. RESULTS: Findings indicated that the serial association between pain intensity and depressive symptoms fully mediated the relationship between sleep quality and both FAB (95% CI [-.125, -.013]), and 8FUPGT (95% CI [.002, .033]) performance. CONCLUSION: Findings highlight the serial association of pain intensity and depressive symptoms with objective postural control performance and the potential for sleep and depression interventions that may maximize functional outcomes in FM.

Individual, family, and social correlates of flourishing outcomes among youth: Findings from the 2016-2017 National Survey of Children's Health.

BACKGROUND: Flourishing is considered an optimal state of well-being and is associated with positive psychological outcomes. Although, individual, family, and social factors may either facilitate or impede flourishing, their unique influence on flourishing outcomes is not well-understood among youth. OBJECTIVE: Using data from the 2016-2017 National Survey of Children's Health (NSCH), this study investigated cross-sectional associations among adverse family experiences (AFE), community safety, family resilience, parental aggravation, and flourishing among youth. PARTICIPANTS AND SETTING: Data from the 2016-2017 NSCH (N = 51,156) were analyzed. Participants included males (n = 26,124) and females (n = 25,032) whose ages ranged from 6 to 17 years old (M = 12.14, SD = 3.45). METHODS: After controlling for relevant demographics, adjusted odds ratios (AORs) using a single-block logistic regression determined the relative likelihood of flourishing. RESULTS: Youth who experienced zero to one AFE (AOR = 2.10; 95% CI [1.95, 2.26]) and two to three AFEs (1.32 [1.20, 1.45]) were more likely to flourish than youth with four or more AFEs. Youth whose parents endorsed low parental aggravation (6.80 [6.41, 7.22]) and moderate parental aggravation (3.70 [3.51, 3.89]) were more likely to be flourishing than youth whose parents endorsed high parental aggravation. CONCLUSIONS: Findings suggest that high parental aggravation is related to poorer flourishing outcomes, after considering community safety, family adversity, family resilience, and demographic characteristics. Providers should consider interventions to support the emotional regulation of parental systems as a means of maximizing developmental outcomes among youth.

A path model of racial/ethnic discrimination and cardiovascular disease risk factors among college students of color.

ObjectiveRacial/ethnic minorities experience disproportionately greater risk to cardiovascular diseases (CVDs). This study examined racial/ethnic discrimination-as a psychosocial stressor-in a path model and its associations with CVD health risk factors among undergraduate students of color (SoC). Participants: The sample included 404 SoC whose ages ranged from 18 to 54 (Mage = 21.82, SD = 5.26; 65% female) from a Hispanic Serving Institution in Southern California. Methods: Participants responded to measures assessing the following traditional and non-traditional CVD indicators: depression, anxiety, and body mass index (BMI). A path model was configured with paths corresponding from racial/ethnic discrimination to BMI, depression, and anxiety symptoms, controlling for gender and age. Results: After accounting for covariates, findings revealed greater levels of racial/ethnic discrimination was uniquely associated with greater BMI, depression, and anxiety symptoms. Conclusions: Findings demonstrate racial/ethnic discrimination is associated with CVD health risk factors among SoC. Data highlight the importance and magnitude of adverse psychosocial experiences on CVD health.

Pain intensity and physical performance among individuals with fibromyalgia in mid-to-late life: The influence of depressive symptoms.

This study investigated the mediating role of depressive symptoms among 147 middle-aged and older adults with FM in the relationship between pain intensity and 4 objective measures of physical performance: Fullerton Advanced Balance scale (FAB), 6-Minute Walk Test (6MWT), 30-Second Chair Stand (30SCS), and 8-Foot Up and Go Test (8FUPGT). Asymptotic mediation analyses revealed that depressive symptoms fully mediated the relationship between pain intensity and FAB (95% CI [-0.40, -0.10]) and 8FUPGT (CI [0.02, 0.11]) and partially mediated the relationship to 6MWT (CI [-9.15, -2.20]) and 30SCS (CI [-0.29, -0.06]). Findings support the evaluation of co-morbid depression in FM.

COVID-19 fear mediates the relationship between perceived risk and preventive behaviors: the moderating role of perceived effectiveness.

OBJECTIVE: To investigate COVID-19 perceived risk and fear as predictors of preventive behaviors among young adult undergraduates, guided by the Extended Parallel Process Model (EPPM). DESIGN: Participants (N = 174;Mage = 21.94, SD = 3.24; 62% Hispanic, 79% women) were recruited from a large public university in Southern California and completed measures at two timepoints over a three-month period. MAIN OUTCOME MEASURES: Participants self-reported COVID-19 risk, fear, preventive behaviors, and perceived effectiveness. RESULTS: Asymptotic moderated mediation indicated that COVID-19 fear fully mediated the association between perceived risk and preventive behaviors. Greater COVID-19 perceived risk was associated with more fear and, in turn, the engagement in more COVID-19 preventive behaviors. Furthermore, in partial support of the EPPM, participants' perceived effectiveness of preventive behaviors moderated the relationship between fear and preventive behaviors where a significant conditional effect was found among only participants endorsing low levels of perceived effectiveness of preventive behaviors. CONCLUSION: This study offers important implications for future health communication strategies by providing a network of associations that either attenuate or promote the engagement in risk-reducing preventive behaviors among young adult undergraduates. Findings highlight the importance of augmenting undergraduate knowledge on health promotion and illness prevention strategies.

Psychometric properties of the Coronavirus Anxiety Scale in a US college sample.

This study evaluated the psychometric properties of the 5-item Coronavirus Anxiety Scale (CAS) among US undergraduates (N = 212). The CAS demonstrated adequate internal consistencies among the sample. CAS scores correlated in a theoretically consistent manner with the Fear of COVID-19 Scale, the Depression Anxiety and Stress Scale-21, and the Satisfaction with Life Scale. A confirmatory factor analysis of a single factor solution yielded good model fit after correlating one pair of item residual variances. Findings indicate good reliability and validity of the CAS among US undergraduates.

Everyday Discrimination and Mental Health Symptoms Among Hispanic and Non-Hispanic Students of Color Attending a Hispanic Serving Institution.

Purpose: Discriminationas a unique psychosocial stressordisproportionately affects the mental health of communities of color as a function of systems of power and oppression. The increasing population of Hispanic undergraduates nationally warrants the importance of understanding the impact of discrimination on the mental health of students within Hispanic Serving Institutions (HSIs), which enroll the most Hispanic students across the nation. This study investigated differences in the relationship between discrimination and mental health symptoms among Hispanic and non-Hispanic students of color (SoC) to better contextualize student experiences within an HSI setting. Methods: This study included 244 SoC (meanage=21.52, standard deviation=2.64; 65% Hispanic/Latinx; 76% female) attending a small private Liberal Arts HSI in Southern California. Participants responded to measures assessing everyday discrimination, depressive symptoms, and anxiety symptoms. Moderation analyses were performed to examine the moderating role of race/ethnicity on the relationship between everyday discrimination and mental health symptoms among Hispanic and non-Hispanic SoC. Results: Both groups generally reported similar levels of everyday discrimination and mental health symptoms. Moderation analyses indicated that, after accounting for covariates, everyday discrimination was associated with more depressive and anxiety symptoms, with race/ethnicity moderating this relationship. A moderation effect was detected among respondents reporting high levels of everyday discrimination wherein Hispanic participants endorsed significantly greater depressive and anxiety symptoms. Conclusion: Findings suggest that within this HSI, Hispanic students may be at greater risk of adverse mental health outcomes compared to non-Hispanic SoC when exposed to high levels of everyday discrimination.